<i>Background:</i> Explanations for associations found between sensory and cognitive function remain unclear. <i>Objective:</i> To assess in an older Australian population: (1) the correlation between sensory and cognitive function across groups with a narrow age range; (2) any independent association between sensory and cognitive impairment. <i>Methods:</i> We examined 3,509 non-institutionalised residents aged 50+ years in the second cross-sectional survey of the Blue Mountains Eye Study (1997–2000). Visual impairment was defined for best-corrected visual acuity (VA) <6/12 in the better eye, moderate to severe hearing loss for hearing threshold >40 dB (better ear), and likely cognitive impairment for Mini-Mental State Examination (MMSE) <24 points. <i>Results:</i> We found likely cognitive impairment in 3.3%, vision impairment in 2.7% and moderate to severe hearing loss in 10.5% of this population. Correlation between VA or hearing threshold and MMSE score increased with age. After adjusting for age, weak but significant correlation was evident in the normal ageing sample between vision and MMSE (r = 0.12 with vision items included and r = 0.11 with vision items excluded, both p < 0.0001), and between hearing thresholds and MMSE (r = –0.12, p < 0.0001). After adjusting for age, sex, education and history of stroke, persons with vision impairment had a lower mean MMSE score than those with normal vision, regardless of whether vision-related items were included (27.1 vs. 28.6, p < 0.001) or excluded (19.8 vs. 21.0, p < 0.001). Similarly, persons with moderate to severe hearing loss had a lower mean MMSE score than those without hearing loss (28.1 vs. 28.7, p < 0.001). Persons with likely cognitive impairment also had lower mean VA and higher mean hearing threshold than those without, after adjustment. <i>Conclusions:</i> We have documented an age-related correlation between sensory and cognitive function in a normal ageing sample. The association between sensory impairment and likely cognitive impairment remained significant after excluding vision-related MMSE items and adjusting for confounding factors. Our data suggest that age-related decline and the effect of visual impairment on the measurement of cognition only partly explain the association between sensory and cognitive impairments in older persons.
In Brief Objective To identify potential and modifiable risk factors for tinnitus in a population of older adults. Study Design Cross-sectional study. Detailed questionnaires were interviewer-administered in a representative sample of 2015 persons aged 55+ yr, living in an area west of Sydney, Australia. Air- and bone-conduction audiometric thresholds were measured from 250 to 8000 Hz and from 500 to 4000 Hz, respectively. TEOAE and SOAE were measured for both ears. Results After adjusting for multiple variables in a Cox proportional hazards model, factors that significantly increased the risk of tinnitus were poorer hearing and cochlear function, self-reported work-related noise exposure, and history of middle ear or sinus infections, severe neck injury or migraine. Conclusion Interventions aimed at reducing age-related hearing loss, particularly by reducing excessive work-related noise exposure, and the effective, timely treatment of ear-related infections, may all decrease the risk of tinnitus. Worldwide to date, there have been relatively few epidemiological studies of tinnitus in large, older populations that have comprehensively assessed its risk factors. Even fewer have used objective measures in hearing examinations. The Blue Mountains Hearing Study (BMHS), conducted from 1997 to 1999, examined 2015 participants aged 55 years or older living in a defined area, west of Sydney, Australia, and has assessed risk factors for tinnitus. In a multivariate model, factors that significantly increased the risk of tinnitus were poorer hearing and cochlear function, self-reported work-related noise exposure, and a history of middle ear or sinus infections, severe neck injury, or migraine. It is possible that timely health interventions to reduce or limit these exposures and the development of age-related hearing loss could decrease tinnitus risk.
The Listening in Spatialized Noise test (LISN)® produces a virtual three-dimensional auditory environment under headphones. Various measures assess the extent to which either spatial, vocal, or spatial and vocal cues combined increase a listener's ability to comprehend a target story in the presence of distracter sentences, without being affected by differences between participants in variables such as linguistic skills. Ten children at risk for auditory processing disorder (APD group) were assessed on the LISN, as well as a traditional APD test battery. The APD group performed significantly more poorly on all LISN measures than 48 age-matched controls. On the spatial advantage measure, the APD group achieved a mean advantage of only 3.7 dB when the distracters were spatially separated from the target by ±90°, compared to 10.0 dB for the controls—the 6.3 dB difference significant at p < 0.000001, with nine children scoring outside the normal range. The LISN was considered a promising addition to an APD test battery.
Research has shown that the Pediatric Speech Intelligibility Test (PSI; Jerger and Jerger, 1984) is a sensitive tool for diagnosing auditory processing disorder (APD) in young children. The PSI is a speech test which utilises competing sentences presented dichotically and monotically at various message to competition ratios (MCRs). The purpose of the present study was to develop an Australian version of this test for use in local clinics. The Macquarie Pediatric Speech Intelligibility Test (MPSI) was recorded using Australian speakers, in order to control for linguistic differences which could affect performance on the test by Australian children. Normative data was collected from 51 normally hearing Australian children aged 7.0 to 8.11 years. The scores below which a child's performance on the MPSI is considered indicative of APD were found to be comparable to those calculated for the original North American version of the test. No significant differences in performance between 7- and 8-year-olds were detected for either the monotic or dichotic conditions of the MPSI. The degree of right or left ear advantage on the dichotic task was very slight, regardless of handedness, making differentiating between the right and left ears when tabulating cut-off scores unnecessary. The preliminary results indicated that the MPSI will be a valuable tool in the identification of APD in the Australian school-aged population.
In this study, monosyllabic Mandarin speech test materials (MSTMs) were developed for use in word recognition tests for speech audiometry in Chinese audiology clinics. Mandarin monosyllabic materials with high familiarity were designed with regard to phonological balance and recorded digitally with a male voice. Inter-list equivalence of difficulty was evaluated for a group of 60 subjects (aged 18–25 years) with normal hearing. Seven lists with 50 words each were found to be equivalent. These seven equivalent lists were used to measure performance-intensity (PI) functions for a group of 32 subjects with normal hearing and a group of 40 subjects with mild to moderate sensorineural hearing loss. The mean slope of PI function was found to be 4.1%/dB and 2.7%/dB, respectively. The seven lists of Mandarin monosyllabic materials were found to have sufficient reliability and validity to be used in clinical situations.
The purpose of this study is to develop and evaluate disyllabic Mandarin speech test materials (MSTMs) in order to facilitate wider use of speech audiometry in Chinese audiology clinics. Phonologically balanced Mandarin disyllabic materials with high familiarity were designed based on the basic rules for developing speech materials and the particular characteristics of Mandarin, and recorded digitally. In order to establish the validity and reliability of these Mandarin disyllabic materials, equivalence of difficulty between the word lists was evaluated for a group of 60 subjects (age-range 18–25 years) with normal hearing. Subsequently, performance-intensity (PI) functions were measured in a group of 30 subjects with normal hearing (age-range 18–25 years), and a group of 35 subjects with sensineural hearing loss. The nine lists of Mandarin disyllabic materials were found to have sufficient reliability and validity to be used in clinical situations
This study aimed to evaluate the role of spectral fine structure and envelope information in Mandarin tone perception for sensorineural hearing-impaired patients.The linear predictive coding technique was applied to synthesize 128 tokens having spectral fine structure from one tone of a monosyllabic word and spectral envelope from other tones with the same syllable. There after, the tone response performance was assessed using these 128 speech materials for 20 normal-hearing and 48 sensorineural hearing-impaired patients, including 20 with moderate, 20 with moderate to severe, and 8 with severe hearing loss.99.7%, 97.7%, 96.3% and 83.0% of the mean tone responses were consistent with spectral fine structure for the normal hearing, moderate, moderate to severe, and severely hearing-impaired groups, respectively. No tone recognition responses were observed in consistent with spectral envelope cues. There was a significant difference in tone recognition among the normal hearing group and three hearing impaired groups (χ(2) = 59.2, P < 0.001). The negative correlation between the averages for pure-tone hearing thresholds at frequencies of 500, 1000, and 2000 Hz and tone responses that were in consistent with spectral fine structure for the hearing-impaired subjects (r = -0.643, P < 0.001).For both normal-hearing and hearing-impaired subjects, spectral fine structure plays an important role in tone recognition, and the impact of changing spectral envelope cues on tone recognition is negligible, when spectral fine structure cues are present. Sensorineural hearing impaired patients showed a progressive decrease in the recognition of lexical tones based on spectral fine structure cues, as their hearing loss becomes more severe.
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